Scapular spine fractures after reverse total shoulder

The authors sought to determine the sensitivity of plain radiographs to detect scapular fractures after reverse shoulder arthroplasty, to test the reliability of a proposed classification, and to evaluate risk factors. They matched 53 patients with scapular fractures after reverse total shoulder to 212 patients with reverse total shoulders but no known fracture.

Reviewers accurately diagnosed 78.8% of fractures and 97.4% of controls.

17 patients in the fracture group did not have a visual fracture on plain radiographs at the initial presen- tation of pain.

Of 16 scapular spine fractures, 14 occurred from a screw tip. Most of the scapular spine fractures (11 of 16) occurred from the tip of the most posterior or superior screw, whereas 3 occurred from the tip of the center screw (all with anteverted orientation).

Osteoporosis was present in 30.8% of fracture patients compared with 18.4% of control patients.

Smoking was present in 19.2% of fracture patients com- pared with 11.8% of control patients, and prolonged steroid use was present in 17.3% of fracture patients compared with 9.9% of control patients.